8/4/2019 Trauma Symposium

1/12

EDUCATION

CARE HOPE

Jointly sponsored by

November 2 - 4, 2011

Galt House Hotel

141 N. 4th Street

Louisville, Kentucky

Kentucky Statewide

Trauma and Emergency Medicine Symposium

RESEARCH

Trauma Symposium.indd 1 8/26/11 4:37

8/4/2019 Trauma Symposium

2/12

Kentucky Statewide Trauma and Emergency Medicine Symposium 2011

Planning Committee Co-Directors

Mary E. Fallat, M.D.Hirikati S. Nagaraj,Proessor and Division Chie, Pediatric SurgeryUniversity o Louisville School o MedicineChie o SurgeryKosair Childrens HospitalLouisville, Kentucky

David S. Foley, M.D., FAAP, FACSAssociate Proessor, Division o Pediatric SurgeryDepartment o SurgeryUniversity o Louisville School o MedicineDirector o Trauma and Burns, Kosair Childrens HospitalLouisville, Kentucky

Glen A. Franklin, M.D.Associate Proessor o SurgeryDepartment o SurgeryUniversity o Louisville School o MedicineDirector, Trauma Outreach & Prevention Program

Medical Director, SICU and Burn UnitUniversity o Louisville HospitalLouisville, Kentucky

Joseph A. Iocono, M.D.Associate Proessor o Surgery and PediatricsUniversity o Kentucky College o MedicineDivision Chie, Pediatric SurgeryDirector, Pediatric Trauma ProgramKentucky Childrens HospitalUniversity o Kentucky HealthcareLexington, Kentucky

Paul A. Kearney, Jr., M.D.Proessor o SurgeryDepartment o General Surgery

University o Kentucky College o MedicineChie, Section o Trauma and Critical CareUniversity o Kentucky HospitalLexington, Kentucky

Julia E. Martn, M.D., FACEPAssociate Proessor o Emergency MedicineUniversity o Kentucky College o MedicineUniversity o Kentucky HospitalLexington, Kentucky

General Session Guest Faculty

Jose R. Maldonado, M.D., FAPM, FACFEAssociate Proessor o Psychiatry and Behavioral SciencesStanord University School o MedicineStanord, Caliornia

Jay Wayne Meredith, M.D., FACSRichard T. Myers Proessor and ChairmanDirector, Division o Surgical SciencesWake Forest University School o MedicineExecutive Director, Childress Institute or Pediatric TraumaWake Forest University Baptist Medical CenterWinston-Salem, North Carolina

Michael F. Rotondo., M.D., FACSProessor and ChairmanDepartment o SurgeryChie o Surgery

The Brody School o MedicineEast Carolina University

Director, Center o Excellence or Trauma and Surgical Critical CarePitt County Memorial HospitalGreenville, North Carolina

Michael G. Smith, BS, MICPChair and Lead InstructorEmergency Medical and Health Services

Tacoma Community CollegeTacoma, Washington

General Session Kentucky Faculty

Melissa Currie M.D., FAAPDirector, Division o Forensic Medicine

Associate Proessor

Department o PediatricsUniversity o Louisville School o MedicineLouisville, Kentucky

Wendy F. Hansen, M.D.Chairman, Department o Obstetrics and GynecologyDivision o Maternal Fetal MedicineUniversity o Kentucky College o MedicineLexington, Kentucky

Daniel J. OBrien, M.D., FACEP, FAAEMAssociate Proessor, Department o Emergency MedicineUniversity o Louisville School o MedicineLouisville, Kentucky

J. David Richardson, M.D.

Proessor o SurgeryUniversity o Louisville School o MedicineLouisville, Kentucky

Mark W. Rukavina, M.D.Medical Director, Emergency DepartmentMarcum and Wallace Memorial Hospital

Irvine, Kentucky

Henry Spiller, MS, D.ABAT, FACCTDirector, Kentucky Regional Poison CenterLouisville, Kentucky

Barbara Weakly-Jones, M.D.State Medical Examiner, retired

Jeerson County CoronerLouisville, Kentucky

Trauma Symposium.indd 2 8/26/11 4:37

8/4/2019 Trauma Symposium

3/12

POLICY ON DISCLOSURE

Norton healthcare adheres to the KMA Essential Areas and Policies, including the Standards or Commercial Support,regarding industry support o CME. All individuals in a position to control the content o this educational activity (course

Director, planners, and presenters) must disclose all relevant nancial relationships they have with commercial interestsas well as the nature o the relationship that may be a potential confict o interest during the planning process. These areassessed by the Oce o CME to ensure adequate resolution o any identied conficts prior the activity. Disclosure to acultyand commercial relationships, as well as the discussion o unlabeled or unapproved us o any drug, device, or procedure bythe aculty, will be disclosed on site to the potential learners in multiple ways. Further, physician attendees will be asked toevaluate the speakers content or bias and balance at the symposium.

Speaker Commercial Interest Relevant Financial Relationship / Role

Theresa Baker, RN None No real or potential conicts to declare

Melissa Currie, M.D. None No real or potential conicts to declare

Mary E. Fallat, M.D. None No real or potential conicts to declare

David S. Foley, M.D. None No real or potential conicts to declare

Glen Franklin, M.D. None No real or potential conicts to declare

Wendy F. Hansen, M.D. None No real or potential conicts to declare

Joseph A. Iocono, M.D. None No real or potential conicts to declare

Jose Maldonado, M.D. None No real or potential conicts to declare

Jay Wayne Meredith, M.D. None No real or potential conicts to declare

Daniel OBrien, M.D. None No real or potential conicts to declare

J. David Richardson, M.D. None No real or potential conicts to declare

Michael F. Rotondo, M.D. None No real or potential conicts to declare

Mark Rukavina, M.D. None No real or potential conicts to declare

Michael G. Smith, BS, MICP None No real or potential conicts to declare

Henry Spiller, MS, D.ABAT, FACCT None No real or potential conicts to declare

Barbara Weakley-Jones, M.D. None No real or potential conicts to declare

Symposium Planning Committee None No real or potential conicts to declare

No aculty member or member o the Planning Committee has any nancial confict(s) to disclose.

Trauma Symposium.indd 3 8/26/11 4:37

8/4/2019 Trauma Symposium

4/12

Kentucky Statewide Trauma and Emergency Medicine Symposium 2011

Dear Colleague,

On behal o Norton Healthcare, University o Louisville Hospital, University o Kentucky Healthcareand University o Kentucky Childrens Hospital, it is our privilege to invite you to participate in theKentucky Statewide Trauma and Emergency Medicine Symposium 2011. Now in its sixth year in

joint sponsorship, this event provides an exciting opportunity or health care proessionals seekinginnovative approaches to trauma and emergency care. The program will cover clinical managemento the trauma patient, including pre-hospital care, resuscitation, acute care and general practiceissues. Two paired lectures will cover the House Bill 285 Legislation mandate requirements orPediatric Abusive Head Trauma. Designed or the team approach, this multidisciplinary orum willeature national and local physicians, nurses, medical examiners and other experts.

Conference ProgramPre-Conerence Workshops

The Advanced Burn Lie Support (ABLS) Provider CourseWednesday, November 2, 2011Location: Galt House Hotel

The Advanced Burn Lie Support (ABLS) Provider Course is an eight-hour course or physicians,nurses, physician assistants, nurse practitioners, and paramedics. The course provides guidelines inthe assessment and management o the burn patient during the frst 24 hours post injury. Followinga series o lectures, case studies will be presented or group discussions. The attendee will be givenan opportunity to work with a simulated burn patient to reinorce the assessment, stabilization, andthe American Burn Association transer criteria to a Burn Center. Final testing consists o a writtenexam and a practical assessment return demonstration.

Cost: No Charge

Registration: please contact Theresa Baker directly by telephone (502) 562-3929 or by e-mail:Therebak@ulh.org. Included in this course is the manual, study guide, test, and continuing educationcredits.

Limited to 20 registrants.

The American Burns Association (ABA) designates this continuing medical education activity or upto 7.25 credit hours in Category 1 o the Physicians recognition Award o the American Medical

Association. This program also has been approved by AACN Certifcation Corporation guidelines or7 contact hours, CERP Category A. For Nursing CE credit inormation, call Theresa Baker directly.

7:30 A.M Registration8:00 A.M. 4:00 P.M.

Objectives:Evaluate a patient with a serious burn.1.Determine the magnitude and severity o the burn injury.2.Identiy and establish priorities o treatment or the burn patient.3.Manage the airway and support ventilation or the burn patient.4.Initiate and monitor uid resuscitation or the burn patient.5.

Apply correct methods o physiological monitoring or the burn patient.6.Determine which patients should be transerred to a burn center.7.Organize and conduct the inter-hospital transer o a seriously injured burn patient.8.

Instructor:Theresa Baker, RN, BSN

Trauma Outreach and Prevention CoordinatorTrauma InstituteUniversity o Louisville HospitalLouisville, KYPediatric Trauma Resuscitation Course or the Pre-Hospital and Emergency Department

Planning Committee

Penne Allison, R.N., B.S.N., MSOM(University o Kentucky)

Helen Anderkin, (Norton HealthcareCME)

Theresa Baker, R.N., B.S.N.(University o Louisville Hospital)

Donna Collins (University oLouisville Hospital)

Carol Fout-Zignani, B.S.N., M.S.N.,C.C.M.E.C. (Norton HealthcareCME)

Lisa Fryman, R.N. (University oKentucky)

Vicki Hardwick-Barnes, R.N.,M.S.N. (Kosair Childrens Hospitalo Norton Healthcare)

Patricia K. Howard, R.N. Ph.D.(University o Kentucky)

Ben Hughes, RN, MSN, MS,CMTE, CCRN (University oLouisville Hospital)

Shelly Marino, R.N. (KentuckyChildrens Hospital o the Universityo Kentucky)

Bari Lee Mattingly, R.N. (KentuckyChildrens Hospital o the Universityo Kentucky)

Ashlee Melendez, B.S.N., M.S.P.H.(University o Louisville, Departmento Emergency Medicine)

Kenelle Sweet, R.N. (University oKentucky)

Joyce Swim, M.B.A. (University oKentucky)

Debora L. Williams, B.S.N., R.N.

B.C. (System Educator, NortonHealthcare Institute or Nursing)

Trauma Symposium.indd 4 8/26/11 4:37

8/4/2019 Trauma Symposium

5/12

Providers

Wednesday, November 2, 2011Location: Galt House Hotel

This one day course will cover the basics o pediatric trauma resuscitation. It is designed or pre-hospitaland emergency department providers. Guidelines and inormation will be presented on initial patientevaluation and resuscitation, chest and abdominal injuries, head injuries, orthopaedic injuries, and burnresuscitation and management. At the conclusion o the course, case scenarios will be provided orattendees to consolidate knowledge acquired during the morning sessions.

This course does not have a limited attendee number or registration.

Cost: $30.00

Agenda7:00 A.M. Registration8:00 A.M. - 9:00 A.M. Initial Resuscitation and Management o the Pediatric Trauma Patient9:00 A.M. 10:00 A.M. Abdominal Injury10:00 A.M. - 10:15 A.M. Break10:15 A.M. - 11:00 A.M. Chest Injury11:00 A. M. - 12:00 P.M. Head Injury12:00 P.M. 1:00 P.M. Lunch (provided)1:00 P.M. 2:00 P.M. Resuscitation and Management o Pediatric Burns2:00 P.M. 3:30 P.M. Case scenarios3:30 P.M. Adjournment

Instructor:David S. Foley, M.D., FAAP, FACS

Assistant Proessor, Division o Pediatric SurgeryDepartment o SurgeryUniversity o Louisville School o MedicineDirector o Trauma and Burns, Kosair Childrens HospitalLouisville, Kentucky

Objectives:

1. Identiy basic principles o pediatric trauma evaluation and resuscitation.2. Gain specifc knowledge in the identifcation and management o pediatric chest, abdominal, head and

orthopaedic injuries.3. Explain the basic principles o resuscitation and the management o pediatric burns.4. Demonstrate skill needs based on case scenarios.

Trauma Symposium.indd 5 8/26/11 4:37

8/4/2019 Trauma Symposium

6/12

Kentucky Statewide Trauma and Emergency Medicine Symposium 2011

General Sessions

Thursday, November 3, 20117:00 A.M. Registration / Buet Breakast ~ Exhibits open

8:00 A.M. Welcome / Opening RemarksBen Hughes

8:15 A.M. Opening Keynote: Trauma Systems: One SizeDoes Not Fit AllMichael F. Rotondo, M.D.Desired practice change: Providers workcollaboratively to develop trauma systems.

9:15 A.M. Trauma System or KentuckyJ. David Richardson, M.D.Desired practice change: The Last Man Standing

10:00 A.M. Break ~ Exhibits open

10:15 A.M. Controversies in Pediatric Termination o

Resuscitation ater Out o Hospital TraumaticCardiopulmonary ArrestMary E. Fallat, M.D.Desired practice change: Improve knowledgebase o the outcome o pediatric out o hospitaltraumatic cardiopulmonary arrest.

11:00 A.M. Signs and Symptoms o DrowningBarbara Weakley-Jones, M.D.Desired practice change: Recognize determination inthe cause o death.

11:45 A.M. Lunch (provided) Exhibits open

12:45 P.M. Aternoon Keynote: Update on Trauma in PregnancyWendy Hansen, M.D.

Desired practice change: Have a working knowledgeo the team approach to the pregnant trauma patient.

1:30 P.M. Pediatric Abusive Head Trauma: Part IMelissa Currie, M.D.Desired practice change: Recognize subtle signs andsymptoms o pediatric abusive head trauma.

2:15 P.M. Break ~ Exhibits open

2:45 P.M. Pediatric Abusive Head Trauma: Part IIMelissa Currie, M.D.Desired practice change: Recognize subtle signs andsymptoms o pediatric abusive head trauma.

3:30 P.M. Evaluation / Adjournment

Friday, November 4, 2011

7:00 A.M. Registration / Buet Breakast ~ Exhibits open

7:30 A.M. Welcome / Opening RemarksBen Hughes

7:45 A.M. Morning Keynote: People Care: Remembering WhoWe Work ForMichael G. Smith, BS, MICPDesired practice change: Recognize patients asindividuals.

8:45 A.M. Air Ambulances in Kentucky

Daniel OBrien, M.D.Desired practice change: Recognize the currentstate o air ambulances in Kentucky

9:30 A.M. Break ~ Exhibits open

10:00 A.M. Vascular Injuries: Pre-hospital to Defnitive CareJay Wayne Meredith, M.D.Desired practice change: Recognize the potential orvascular injuries and manage them.

11:00 A.M. Assessment and Management o the Potential OrgaDonor Glen Franklin, M.D.Desired practice change: Early identifcation opotential organ donors

11:45 P.M. Lunch (provided) Exhibits open

12:30 P.M. Aternoon Keynote: Level IV Trauma DesignationMark Rukavina, M.D.Desired practice change: Optimize and standardizecare or the trauma patient in the state o Kentucky

1:30 P.M. Recognition and Management o Delirium in theAcute Care SettingJose Maldonado, M.D.Desired practice change: Improved assessment,recognition and management o delirium

2:15 P.M. Bath Salts (synthetic cathinones): A New Group oDrugs to AbuseHenry Spiller, MS.D.Desired practice change: Recognition and awareneso this group o drugs

3:00 P.M. Evaluation / Adjournment

Trauma Symposium.indd 6 8/26/11 4:37

8/4/2019 Trauma Symposium

7/12

General Sessions Course Objectives

Thursday General Session Objectives

Defne characteristics o trauma systems. (Rotondo)1.List actors inuencing trauma systems today. (Rotondo)2.Outline possibilities or a statewide trauma system in Kentucky.3.(Richardson)Identiy potential stumbling blocks or a statewide trauma system in4.Kentucky. (Richardson)Indentiy challenges o treatment o pediatric out o hospital5.traumatic cardiopulmonary arrest or medical providers in and out othe hospital setting. (Fallat)Outline the mechanisms o drowning. (Weakley-Jones)6.Defne the determination in cause o death o drowning.7.(Weakley-Jones)Defne the incidence and causes o both maternal and etal injury8.during pregnancy and know the relationship o maternal injury toetal injury. (Hansen)Outline the approach to perorm a timely and comprehensive etal9.assessment in the injured pregnant patient suering either major orminor trauma. (Hansen)

Appropriately evaluate and ollow up the child with abusive head10. trauma. (Currie)Dierentiate the range o outcomes or victims o pediatric abusive11.head trauma. (Currie)

NursesNorton Healthcare is an Approved Provider o continuing nursingeducation by the North Carolina Nurses Association, an accreditedapprover by the American Nurses Credentialing Centers Commission on

Accreditation.

ANCC # 094-80-074 5.50 contact hoursANCC # 094-80-075 6.00 contact hours. Participants must attend theentire course and complete the evaluation to receive contact hours.

Sponsors reserve the right to substitute speakers with equivalentcredentials or both days. Norton Healthcare adheres to the ANCCs

policies, including the standards or commercial support, regardingindustry support o continuing nursing education and non-endorsemento o label use o a product or which it was attended by the Food andDrug Administration.

For questions related to nursing credit, please call Debora Williams atNorton Nursing Institute (502) 629-7359 or email:debbie.williams@nortonhealthcare.org

Emergency Medical Technicians and ParamedicsEducation credit will be provided by the Kentucky Board o EmergencyMedical Services and the Kentucky Emergency Medical Services orChildren Project. A certifcate will be provided to each attendee.For questions related to EMT/paramedic credit, please contact theKentucky Board o EMS at (502) 564-8963.

Other Allied Health ProessionalsAll other disciplines (i.e., respiratory therapists, OR techs, etc.) or whompreapproval has not been achieved will be provided a certifcate oattendance ater the symposium. Each o these proessionals will beresponsible or submission to their proessional boards i credit is desired

Pediatric Trauma Resuscitation Course or Pre-Hospital andEmergency Department ProvidersPhysician CME Designation: Norton Healthcare designates thiseducational activity or a maximum o6.25 AMA PRA Category 1Credits. Physicians should only claim credit commensurate with theextent o their participation in the activity.

Nursing CNE:094-80-073 Approved or 6.25 contact hours

General SessionsPhysician CME Designation: Norton Healthcare designates thiseducational activity or a maximum o11.50 (5.50 hours on Thursday,6.00 hours on Friday) AMA PRA Category 1 Credits. Physiciansshould only claim credit commensurate with the extent o theirparticipation in the activity.

Norton Healthcare is an Approved Provider o continuing nursingeducatoin by the North Carolina Nurses Association, an accreditedapprover by the American Nurses Credentialing Centers Commission on

Accreditation.

Nursing CNE:Thursday, November 3, 2011 094-80-073 5.50 contact hoursFriday, November 4, 2011 094-80-074 6.00 contact hours

Friday General Session Objectives

Identiy 3-5 common qualities o every patient encounter. (Smith)1.Explain the dierence between caring or versus taking care o2.patients. (Smith)Interpret current data related to the state o air ambulances in3.Kentucky. (OBrien)Recognize the relationship o air ambulance history and4.development to trauma care in Kentucky. (OBrien)Control central vascular injuries in the feld. (Meredith)5.Recognize and repair vascular injuries in the hospital. (Meredith)6.

Review Kentuckys experience with organ donation. (Franklin)7.Discuss the potential donor and management goals. (Franklin)8.List education and care requirements or Level IV trauma9.designation by the state o Kentucky. (Rukavina)Outline the neuropathophysiology o delirium. (Maldonado)10.

Apply research-based, eective prevention and treatment options11.or the delirium patient. (Maldonado)Evaluate recent experiences with and evolving understanding o12.synthetic cathinones in the United States. (Spiller)Describe clinical eects, recommended treatments and expected13.outcomes with the synthetic cathinones. (Spiller)

Continuing Education

PhysiciansThese activities have been planned and implemented in accordancewith the Essential Areas and Policies o the Accreditation Council orContinuing Medical Education through the joint sponsorship o NortonHealthcare, the University o Louisville Hospital and the University oKentucky.

Accreditation: Norton Healthcare is accredited by the Kentucky MedicalAssociation to provide continuing medical education or physicians.Reer to each activitys description below or designation statement o

AMA PRA Category 1 Credits . For questions related to CME, pleasecontact Carol Fout-Zignani, Director o Norton Healthcare CME, at (502)629-8574, ax (502) 629-6556, or email:

Trauma Symposium.indd 7 8/26/11 4:37

8/4/2019 Trauma Symposium

8/12

Kentucky Statewide Trauma and Emergency Medicine Symposium 2011

General Inormation

Target AudienceThis program is directed toward physicians, nurses, nurse practitioners,

physician assistants, EMT/EMT-Ps, respiratory therapists, radiologytechnicians, and other allied healthcare proessionals dealing withemergency and critical care patients.

Location and AccommodationsThe Galt House Hotel is a business-riendly hotel located in centralLouisville, close to Riverront Plaza Belvedere, Kentucky InternationalConvention Center, and Muhammad Ali Center. Additional points ointerest include Louisville Slugger Museum, 4th Street Live, our blocksrom the Kentucky International Convention Center and 5 minutes romLouisville International Airport. The Galt House Hotel is located on 4thStreet. A block o rooms is available in the hotel at the group rate rangeo $159.00, available only until October 2, 2011. Please mention thatyou are attending the Kentucky Statewide Trauma Symposium 2011 toobtain the conerence rate. Reservations and cost are the responsibilityo the individual. To make a reservation, call (502) 589-5200 at extension5915. Parking will be available in the attached parking lot at the cost othe attendee.

For your personal comortFor both the workshops and general sessions, we suggest that youbring a sweater or jacket in order to maximize your comort. It is ourexperience that climate controls do not always conorm to individualpreerences.

Special NeedsPlanners o this activity are committed to making the conerenceaccessible to all individuals. At time o registration, please describe anyauxiliary aids or services (identifed in the American with Disabilities Act)which might be needed. Advance notifcation o any special needs helpus better accommodate your needs. Please outline any special needs at

the time o your pre-registration. Most requests can be obliged.

Trauma Symposium.indd 8 8/26/11 4:38

8/4/2019 Trauma Symposium

9/12

Registration Fees

Pre-Session Courses

Pre-hospital Burns Course: No Cost

Pediatric Trauma Workshop: Cost to all attendees is $30.00. Cost includes break, CE credit.

General SessionsPhysiciansBoth Thursday and Friday (Cost includes 2 breakasts, 2 lunches, 4 breaks, CE credit)$250.00 per person (By September 30, 2011) $300.00 per person (Ater September 30, 2011)

One Day Only (Cost includes 1 breakast, 2 breaks, 1 lunch, CE credit)$175.00 per person (By September 30, 2011) $200.00 per person (Ater September 30, 2011)

Nurses / Physician Assistants/ Paramedics / EMTs / Radiation Techs / Respiratory Therapists / OtherBoth Thursday and Friday (Cost includes 2 breakasts, 4 breaks,2 lunches, CE credit)

$120.00 per person (By September 30, 2011) $130.00 per person (Ater September 30, 2011)

Thursday Only (Cost includes 1 breakast, 2 breaks, 1 lunch, CE credit)$80.00 per person (By September 30, 2011) $85.00 per person (Ater September 30, 2011)

Friday Only (Cost includes 1 breakast, 2 breaks, 1 lunch CE credit)$70.00 per person (By September 30, 2011) $75.00 per person (Ater September 30, 2011)

Employees o both UK and UoL Hospitals / Kosair Childrens Hospital

Find your classifcation above. Subtract $20.00 rom the General Sessioncosts. Same registration deadlines apply.

University o Louisville / University o KentuckyStudents/ Interns / Residents in the Colleges / Schools o Medicine and Nursing

$30.00 per person per day to cover costs o ood. Please complete and sendRegistration Form.

(Accommodations or walk-in registrations cannot be guaranteed.)

Confrmation o Registration / Cancellation o Registration:All registrants will be sent a conrmation i registration is received prior toOctober 24, 2011. Registration ee is reundable i cancelled by participant

prior to October 7, 2011, minus a $30 cancellation ee. Should the sponsorscancel this conerence, registration ees will be reimbursed in ull. However,

no sponsor is responsible or any other costs incurred by the participant.Registration ees are nonreundable ater October 24, 2011.

Trauma Symposium.indd 9 8/26/11 4:38

8/4/2019 Trauma Symposium

10/12

Trauma Symposium.indd 10 8/26/11 4:38

8/4/2019 Trauma Symposium

11/12

Kentucky Statewide Trauma and

Emergency Medicine Symposium 2011

Registration Form

November 2-4, 2011Galt House, Louisville, Kentucky

Registration deadlinesFor hotel and Early bird symposium rate: September 28, 2011

Three convenient ways to register or symposium:Online: http://2011traumasymposium.eventbrite.com/

Via mail: Fill out the orm below and mail check to:

University o Louisville HospitalTrauma/Emergency SymposiumTrauma Institute - ACB Basement530 S. Jackson St.Louisville, Kentucky 40202

* Make check out to University o Louisville Hospital Trauma Institute

Via phone: Donna Collins(502) 562-4060

M.D. Nurse /Nurse Practitioner EMT/Paramedic RT Other

UK Resident/Intern/Student UoL Resident/Intern/Student

Name (Please print clearly)

Street Address City State Zip

Proessional License # State o Licensure

Telephone ( ) Fax ( ) Email Address

Disability accommodations needed. Please describe auxiliary aids or services required.

Pre-Conerence Workshops

Registration or: PRE-HOSPITAL BURNS COURSE: The Advanced Burn Lie Support (ABLS) Provider Course, please contact Theresa Barker

directly by telephone (502) 562-3929 or by e-mail: Therebak@ulh.org.

ABLS Course No Charge Call (502) 562-3929 Limited to 20 $

Pediatric Trauma Resuscitation Course $30.00 $

TOTAL $

Physicians

Thursday, November 3, 2011 $175.00 (By 9/30/11) $200.00 (Ater 9/30/11) $

Friday, November 4, 2011 $175.00 (By 9/30/11) $200.00 (Ater 9/30/11) $

Both Thursday and Friday $250.00 (By 9/30/11) $300.00 (Ater 9/30/11) $

Employee o: Norton Healthcare UK UoL $ -20.00

TOTAL $

Nurses / Physician Assistants/ EMTs /Paramedics /RTs / Other Allied Health

Thursday, November 3, 2011 $80.00 (By 9/30/11) $85.00 (Ater 9/30/11) $

Friday, November 4, 2011 $70.00 (By 9/30/11) $75.00 (Ater 9/30/11)) $

Both Thursday and Friday $120.00 (By 9/30/11) $130.00 (Ater 9/30/11) $

Employee o: Norton Healthcare UK UoL $ -20.00

TOTAL $

Students/Residents/Interns in the Colleges/Schools o Medicine and Nursing

Thursday, November 3, 2011 $30.00

Friday, November 4, 2011 $30.00 $

TOTAL AMOUNT ENCLOSED $

Trauma Symposium.indd 11 8/26/11 4:38

8/4/2019 Trauma Symposium

12/12

RESEARCH EDUCATION

CARE HOPE

Kentucky Statewide Trauma

and Emergency Medicine Symposium 2011

November 2 - 4, 2011

Galt House Hotel

141 N. 4th Street,Louisville Kentucky

Deadline for hotel and early

bird symposium rate:

September 28, 2011

Jointly sponsored by: